Do not close a case due to information reported solely by an Electronic Verification System (EVS) source, unless it matches the participant’s statement.
When an EVS match returns information that indicates that an applicant or participant is ineligible and this information was NOT reported by the participant, contact the participant for additional information. Update the eligibility system with the participants updated statement. If additional verification is required for the eligibility determination, send a Request for Information notice.
Example: An EVS match indicates an undisclosed bank account with a balance that exceeds the resource limit for Non-MAGI MO HealthNet coverage. Staff attempt to call the participant, but receive no answer. Staff send a Request for Information notice requesting verification to validate the EVS match. If a response is not received, the case may close because requested verification was not provided.
Example: An EVS match indicates earnings that exceed the income limit. Staff call the participant, who explains that they worked overtime for two weeks because a co-worker was on medical leave, and that they have returned to their regular schedule. Staff document the participant’s statements in the eligibility system and exclude the two irregular weekly pay stubs. A Request for Information is not sent.